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t.2 biomechanics > midterm 1 > Flashcards

midterm 1 Flashcards

1
Q

whats the point of reference in the sardas chart

A

patient

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2
Q

3 things involved in rom active

A

voluntary, patient moves it, smaller then pasive

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3
Q

key 4 of passive rom

A

in physiological barrier, involuntary, patient not move it, larger then arom

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4
Q

joint play is in what barrier

A

in paraphysiological barrier and is a structural barrier

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5
Q

where is jt play compared in arom and inactive

A

after active and inactive range

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6
Q

where is adjustment made

A

jt play

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7
Q

how many true jts are in the shoulder complex

A

3 gh, scj, acj

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8
Q

what is the 4th shoulder jt not tru BIOMECAHNICAL jt

A

stj scapthoracic

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9
Q

what makes a true jt

A

2 bones that come together and have articular surfaces wrapped by ligamentous structures filled with synovium

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10
Q

how many biomechanical jts there are of shoulder

A

4

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11
Q

whats the only real link to the axial skeleton when it comes to shoulder

A

scj

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12
Q

if scj moves what else moves

A

acj and stj

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13
Q

what are the components of the scj

A

synovial capsule, disk (under clav and above manubrium and cost cart)

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14
Q

scj () more sub or dis

A

subluxates

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15
Q

what direction does the scj sublux and why

A

anterior and superior because of a back sided facet prevent it go posterior and superior cause of pull from trap, lev scap, torque from scalenes

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16
Q

what is lod for sc subluxation

A

posterior inferior

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17
Q

what % of scj is dislocation

A

<1

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18
Q

acj has a disc t or f

A

true

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19
Q

with ue usage disk goes from fibrocartilage to

A

meniscoid

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20
Q

what happens with disc in ue jt

A

it tins out and becomes softer and more pliable with less strength

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21
Q

what hurts moer disclocation or sub of scj

A

subluxation

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22
Q

whats hurts worse, fx clavicale of shoulder separation

A

shoulder separation

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23
Q

what tears with sholder separation

A

anterior capsule, ac lig, cc lig

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24
Q

what do you do with an acute shoulder separatoin

A

SAT, adj, taping, rice surger

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25
Q

what do u do with chronic acj shoulder separation

A

sct

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26
Q

where does the stj sit when sitting

A

siting; t2 (superior angle)
spine; t3
inferior; t7

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27
Q

where does the stj sit when laying down

A

sup ang; t1
spine; t2
inferior; t6

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28
Q

how far does the scap border sit from the sps

A

2 in

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29
Q

how many degrees of movement does the stj have

A

1 degree (elevation and epressioN) and 2 degree (protraction/retraction) and (upward rotation and downward rotation)

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30
Q

whats the primary movement of stj

A

elevation and depression

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31
Q

what is protraction

A

abduction and wraps around the person

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32
Q

what is retraction

A

adduction and brings to the spine

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33
Q

when looking at rotation what is point of reference

A

the inferior angle

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34
Q

inferior ang of scap goes towards arm is what movemetn

A

upward/lateral rotation

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35
Q

inf angle to spine its what move

A

downward/ med rotation

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36
Q

can u do rotation as a isolated movement of scap

A

no

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37
Q

adhesive capsulitis aka

A

frozen shoulder

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38
Q

how musch motion lose with capsulitis

A

1:1, every 1 dgree of gh movement u get 1 degree of movment in scapthor jt

get reduction of abduction

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39
Q

whats the normal motion of movement in sct jt and gh

A

2:1 2 gh 1 sct

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40
Q

what movement causes pain with adhesive capsulitis frozen shoulder

A

abduction

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41
Q

what can cause adhes capsulitis

A

trauma/direct/ indirect/ prolonged over use

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42
Q

what to do with acute acpsuilitis

A

sat, no rest keep moving

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43
Q

what to do with chronics capsulitis

A

sct, usd, heaters, massage

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44
Q

what is scap winging and what muscles involved

A

not good laydown of scap on back,

serratus anterior, subscapularis, rhomboid maj, min

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45
Q

what is codman’s exercise for

A

adhesive capsulitis

stretches casule but no muscle usage: dead weight and move weight in circular motion with whole body

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46
Q

what makes gh not stable

A

large art surface of humerus and small art suface of scap

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47
Q

whats degree # angle of inclination of gh

A

130-150

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48
Q

what is the angle of inclination mean

A

between humeral head and shaft, midline of both

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49
Q

whats the # for angle of torsion of gh

A

30

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50
Q

what is the angle of torsion of gh

A

the angle in resting postion

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51
Q

what is the glenoidal labrum

A

extension of glenoid fossa

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52
Q

what doe the glendoidal labrun deepen and allow

A

it deeps and gives more articulation for the humerus nad allows long ehad of biceps to attach

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53
Q

the glenoidal labrum is () on top and () on bottom

A

loose on top and tight on bottom so don’t dislocate

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54
Q

the glenohumeral capsul is () on top and () on bottom

A

tight on top and loose on bottom

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55
Q

what is the gh capsule supported by

A

subscapularis

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56
Q

what makes the cuff in sits

A

the capsule gh

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57
Q

if have issue with subscap it could cause

A

capsulitis

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58
Q

what make up the coracoacromial arch

A

coracoid process, acromion, coracoacromial lig

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59
Q

what structure if got injured swell or tear can take off 1/3 of protection of gh

A

coracromial lig

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60
Q

what does the coracromial arch protect and do

A

subacromial bursa, rotator cuff tendons (SSp), long head of BB

and keeps humerus form dislocating SUPERIOR

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61
Q

whats the most common sits muscle to be injured

A

supraspinaturs

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62
Q

shoulder saparation involves what jt

A

ac

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63
Q

shoulder dislocation inlves what jt

A

gh jt

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64
Q

what is the usal way of humerus dislocates

A

anterior and inferior

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65
Q

where are the bursae in upper e

A

subacromial and subdeltoid

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66
Q

which bursa usually doesn’t too affected

A

subdeltoid

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67
Q

what is action of busae

A

referees and decresses friction

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68
Q

what position does the gh dislocate

A

hyperextension and er (this makes gh shoved anterior and shoulder blades stay behind)

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69
Q

what are the tests associated with dislocation

A

drawer, apprehension, dugas, feagin (inferior drawer)

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70
Q

what is the premium test for gh dislocation

A

dugas (touch opposite shoulder nad cant lower elbow)

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71
Q

whats the first thing to do when think dislocated shoulder

A

xray to rule out fx

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72
Q

acute tx of dislocation

A

rice, anesthetic relocation or kocher maneuver

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73
Q

what is the kocher maneuver

A

relocation procedure: pull it down, ext rot, abd, add to body, it lifts and I interally rotate

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74
Q

what time frame do u hae to do the kocher maneuver

A

3-4hrs

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75
Q

once do the kocher maneuver then do what

A

check radial, ulnar pulse, if its pale, cold, cyanotic, not strong send to e.r

could block axillary a.

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76
Q

chronic tx of dislocation

A

sct, emns, isometrics, isokinetics, isotonics

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77
Q

what are the 4 cardinal signs of inflammation

A

dalor: pain
rubor: redness
calor: heat
tumor: swelling

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78
Q

where get bursitis usually

A

subacromial bursa, inf to ac, sup to ss tendon

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79
Q

what movemtns cause pain with bursitis and what kind of rom

A

flex, abd, er,

both active and passive

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80
Q

what is soft tissue

A

muscle tendon fascia

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81
Q

what is hard tissue

A

bone ligament jt

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82
Q

if I passively move something and it hurts what kind of tissue is involved

A

hard tissue

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83
Q

burisitis even tho its a soft tissue it acts like a

A

hard tissue

84
Q

what causes dislocation

A

trauma

85
Q

what causes burisiti

A

trauma and overuse

86
Q

what tests used for bursitis

A

push-button, dawbarns

87
Q

what is dawbarns test

A

u push under acromion and have them abduct arm and pain goe away cause biceps and supraspinates get in way of push

88
Q

acut tx of bursitis

A

sat rice

89
Q

chornic tx bursitis

A

sct, mt heaters

90
Q

rom of shoulder complex flexion and muscles involved

A

160, ant delt, long biceps, pec major

91
Q

rom exetension shoulder and muscles

A

60 post delt, teres maj, min, lat dorse, triceps

92
Q

rom adduction shoulder and muscles

A

75 pec maj, lat dorsi, teres maj

93
Q

rom abd shoulder and muscles

A

180, supraspinatus, and middle deltoid

94
Q

what movement needed to get full abdu of shoulder

A

er and inferior sliding of humerus

95
Q

supraspinatus does how much degress of movement for first abduction

A

15

96
Q

protraction rom scap

A

20

97
Q

retraction rom scap

A

30

98
Q

ir rom gh and muscles

A

70 subscapularis and pec major

99
Q

er rom gh and muscles

A

100 infraspinatus and teres minor

100
Q

what syndroms are involved with tos

A

scalenus anticus/anterior, cervical rib, costoclavicular, pect minor/hyperabduction

101
Q

what structures included with tos

A

subclavian vein and artery, brachial plexus

102
Q

what muscles could be involved with costoclavicular syndrome

A

lev scap, platysma, midd scalenes

103
Q

besides syndromes what else can cause tos

A

neurovascular bundle compression, muscle spasm poor posture, trauma

104
Q

with tos where would the subclavian artery be trapped

A

ccs at the clavicle (costoclavicular syndrome)

105
Q

pec minor syndrome traps what pms

A

axillary artery at coracoid process

106
Q

what does scalene sas anterior syndrome cause

A

anterior head carriage

107
Q

what nerve get neuropathy with tos

A

ulnar

108
Q

what tests for tos

A

adson (bring arm away extend head turned and feel pulse go away), for SAS

wright (abduct arm) for PMS

costoclavicular: bring arm forward and jam finger in there for CCS

109
Q

tx tos

A

adjust, sat, sct,surgery (crs)

110
Q

at rest the gh is stabilized by what

A

joint capsule, superior gh lig, ch lig

negative jt pressure

glenoid inclination

111
Q

at weight bearing the gh stabilized by what

A

above supraspinatus ssp lig, and long head of bb

112
Q

rom of elbow flexion and muscles

A

140 brachialis, biceps brachii, brachioradialis

113
Q

wha muscle is ripped with avulsed biceps brachii

A

long head

114
Q

how get avulsed biceps

A

lifting trauma, degeneration,

115
Q

can they lift if avuls biceps

A

yes cause compensate with other msucles, brachialis

116
Q

extension rom elbow and muslces

A

.3 (more women) triceps , anconeus

117
Q

olecranon bursitis aka

A

students elbow

118
Q

how get olecranon bursitis

A

trauma, inferiction, leaning on lebow alot

119
Q

rom supination elbow muscles

A

80 supinator, biceps brachii, brachioradialis,

120
Q

with supination there is more axial force load on what bone

A

ulnar

121
Q

radial neuropathy aka

A

snp, Saturday night paulsy

122
Q

how get snp

A

head bend down, arms abducted and extended

or trauma at mid humerus fx,

123
Q

what are the ways to piss off a nerve

A

wollerian degeneration by compreesoin (like step on it)
cut the nerve
strectch the nerve which causes compression

124
Q

sign of snp

A

wrist drop,

125
Q

rom elbow pronation muscles

A

75 pronator teres, pronator quadratus, brachioradialis,

126
Q

with pronation where is more axial force load on bone

A

radius

127
Q

what muscle does the radial nerve split

A

the supinator

128
Q

what causes ulnar neuropathy

A

trauma or foosh

129
Q

where is the ulnar nerve

A

under pronator teres, through flex carpi ulnaris

130
Q

ulnar neuropathy aka

A

pronator teres syndrome

131
Q

test for ulnar neuropathy

A

+ wartenberg (spread fingers apart, bring together and pinky doesn’t move), +froment(put paper between index and thumb and cant hold it if pulled out) , +tinel (tap on nerve)

132
Q

what jt look at for carrying angle and what bone specifically

A

humero-ulnar jt and trochlea

133
Q

what is the carrying angle in men

A

15

134
Q

if fx troclea and get a varus position what is this called

A

gunstock deformity

135
Q

why do women have a biiger carrying angle

A

cause forarm bones are shorter then males on average

longer trocleas, larger suface areas (superior to inferior length specifically)

136
Q

carrying angle is valgus or varus

A

valgus

137
Q

what bone is involved for the humeroradial jt

A

radial head

138
Q

what bones involved for the radio ulnar artciulation

A

pivoting of radius around ulna

139
Q

the common jt capsule of elbow blends in what what ligs

A

annular lig, mcl,lcl

encases jt on all sides

140
Q

sales sign/fat pad sign is what

A

see in xray to see if common jt capsule is inflammed

141
Q

what are 3 parts of mcl

A

anterior , posterior, transverse

142
Q

what is function of mcl

A

stabilize valgus stress
limit end range extension
resist traction loads

143
Q

medial epicondylitis aka

A

little league elbow, golfers ebow

144
Q

medial and lat epicondilitis is what with what

A

tendonopathy with inflammation

145
Q

tests for medial epicondylitis

A

tinels on ulnar +rev Mills (flex wrist and pronate against resistance)

146
Q

after effects of med epicond

A

wrist flex weakness

147
Q

causes of med epicond

A

repetitive wrist flex and pronations, microtears in soft tissue

148
Q

3 parts of lcl

A

radial, ulnar, annular

149
Q

function of lcl

A

stabilize varus, suprination stress, resists traction loads, stabilizes radial head

150
Q

lateral epicondylitis aka

A

tennis elbow (when they hit back handed)

151
Q

tests for lateral epicondylitis

A

+cozen (fist, wrist extend, doc tries to force into flex), +mills (flex wrist fist, they try to supinate with resistance)

152
Q

affect of lat epic

A

weak wrist ext

153
Q

causes of lat epic

A

repetitive wrist extension and suppinations, microtears in soft tissue

154
Q

annular lig joins what

A

ulnar around radius back to ulna

155
Q

annular lig is #/# of ring

A

4/5

156
Q

what does annular lig part of what groups

A

capsule and lcl

157
Q

al tear aka

A

nursemaids elbow, mall elbow, babysiiterr elbow

158
Q

al tears happen with the swing which includes what 3 movements

A

pronation, extension, distraction

159
Q

what elbow usually get al tear

A

left elbow cause most peeps are right handed when hold hand

160
Q

what is functional paralysis that comes with nursemaid

A

choose not to move it but they can if they haveto

161
Q

what is the al tear/ nursemaids elbow specificcaly (type of injury)

A

annular lig entrapment with radial head subluxation

162
Q

rom flexion wrist muscles

A

75 flexor carpi ulnaris, flexor carpi radialis

163
Q

rom extension wrist muscles

A

74 extensor carpi radialis longus/brevis, extensor carpi ulnaris

164
Q

there is no musclular forces on what row of carpals

A

proximal row (intercalated)

165
Q

intercalated makes the wrist () but is good for ()

A

unstable, good fro movement

166
Q

under compression what carpal flexes and what carpal extends to dissipate stress

A

scaphoid flexes, lunate extends

167
Q

DISI means

A

dosal intercalated segmental instability

168
Q

what Is disi

A

where scaphoid lunate ligament allows for a lot of movement cause it snapped

169
Q

what is the keystone for pivot bone

A

capitate

170
Q

slac injury means

A

scapho lunate advanced collapse

171
Q

what happens in slac injury

A

capitate falls and splits between scaphoid and lunate and can slide into the radius

172
Q

how do you know if they have a slac injury

A

cant flex wrist to 75 degrees

173
Q

in neutral the () and () are packed together

A

capititate and scaphoid

174
Q

in full extension the () and () pack

A

scaphoid and lunate

175
Q

what have adjusting apllications

A

the scaphoid being packed with lunate and capitate

176
Q

how many tunnels are in the wrsit

A

6

177
Q

capral tunnel syndrome involves what bones and nerve

A

pisiform, hamate hook to navicular/trapezium tunne;

median nerve

178
Q

pisiform/hamate tunnel aka

A

tunnel of guyon

179
Q

what boens and nerve involved with tunnel of guyon

A

hamate pisiform tunnel and ulnar nerve

180
Q

what is the normal pressure on the median nerve

A

8 mml merv

181
Q

what is the pressure if cyst on median nerve

A

32 mml merc!

182
Q

what couldbe the etiology of carpal tunnel syndrom

A

compression of tunnel
direct trauma with swelling
lunate/capitate fx/subluxation
sol

183
Q

what tests for carpal tunnel

A 
esthetic sensations
tinels (tap on nerve0
phalens (back of hands together push on  median nerve)
reverse phalen (prayer)
carpal compression
184
Q

what is associated with the tunnel of guyon (symptoms)

A

ulnar triad

185
Q

what is the ulnar triad

A

tenderness, clawing, hypothenar atrophy

186
Q

tx of tunnel issues

A 
rule out fx
de-inflame
adjust
elevation
tape styloid process/retinaculum
187
Q

rom unlar deviation/adduction and muscles

A

35 flexor carpi ulnaris

extensor carpi ulnaris

188
Q

rom radial deviation and muscles

A

21 extensor carpi rad longus

abductor pollicis longus and extensor pollicis brevis

189
Q

biomechanics of carpals has ()

A

reciprocal motion

190
Q

if prozimal row goes right ethe distal row goes

A

left

191
Q

whats importance of reciprocal motion

A

increases range of motion of wrist

keeps ligaments from overstretching on only one ligament

192
Q

adjusting application of carpals (no deviation cause of)

A

lil to no deviation due to closed pack position in full extension

lil to no deviation due to splaying

193
Q

de quervians disease is what

A

stenosing tenosynovitis (sheath closes on part of tendon (stenotic)

194
Q

stenose means

A

constrict

195
Q

patent means

A

open

196
Q

what muscles involved with de quervians disease

A

abductor polllicis longs, extensor pollicis brevis

197
Q

specifically de quervains disease has the inflamed tenon on what are

A

radial styloid process

198
Q

etiology of de quervians

A

overuse trauma of thumb, wrist, direct trauma

199
Q

presentation of de quervains disease

A

increased pain on thumb/wrist exetension
increased pain on general wrist flexion
tender on radial styloid process

200
Q

what test for de quervanisn

A

+ finklesteins (tuck thumb in palm and then ulnar deviate)

201
Q

tx of de quervains

A

adjust immobilize, surgery

cortisone

202
Q

dupuytrens contracture is what

A

nodule formation on hand flexor tendons/aponeurosis

203
Q

what causes dupuytrens

A

unknown genetics

204
Q

presentation of dupuytrens

A

flexion deformity of hand
fingers drawn into palm
pain may/may not present

205
Q

tx of dupuytrens

A

ems (lvdc with iontophoresis;mg)
stretching
cortisone
surgery

t.2 biomechanics (2 decks)

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